Abdominal trauma: A five year experience in a military hospital

Julius AA Awe¹* and Soliman AM²

¹Consultant General Surgeon and Associate Professor of Surgery. Now College of Health Sciences, Department of Surgery, Igbinedion University, Okada, Edo state. Nigeria

²Northern Area Armed Forces Hospital, King Khalid Military City, P.O. Box 10018, Hafr Al-Batin 31991, Saudi Arabia.

*Corresponding Author E-mail: doset2007@yahoo.com

Accepted 07 August, 2013

Abstract

Trauma is a leading cause of death in the age group 1-50 years. Most of the usual causes outlined in the published literature include road traffic accidents, stab wounds, falls from height, gunshot wounds etc. The abdomen is traumatized in about 10-15% of trauma cases and this is probably because of its large surface area when compared with the other parts of the body. This retrospective study was carried out over a period of five years from January 2003 to December 2007. It highlights the incidence, gender distribution, available modalities of investigation and methods of improving management and prognosis of abdominal trauma in our hospital. There were 99 purely abdominal trauma patients involved in the review over this five-year period.  Penetrating injuries were seen in 15 patients (15.2%) and non-penetrating in 84 patients (84.8%). Gunshot injuries and fall from heights were (2.02%) and (3.05%) of the injuries respectively. The overall ratio of non-penetrating to penetrating injuries was approximately 6:1. Wound sepsis was the most common complication of those patients that had surgical exploration.  Mortality rate was 10.1%. The major cause of death was irreversible hypovolaemic shock due to severe blood loss either prior to arrival in hospital, or uncontrollable haemorrhage in the operating room and extreme coagulopathy in the immediate post-operative period. We advocate rapid transportation and prompt resuscitative measures, availability of modern technological investigations as well as surgical and intensive therapy skills, in improving the outcome for victims of abdominal trauma whatever the aetiology. Trauma being a preventable disease we also recommend health education for drivers and road users, conspicuous display of vehicle speed limits as well as identification of known accident black spots.  Awareness of road users of the major factors in the causation of vehicular accidents will play a significant role in the prevention of abdominal trauma.

Keywords: Review, Trauma, Abdomen.